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Premature mortality from cardiopulmonary diseases has been consistently linked with particulate air pollution. The underlying mechanisms, however, are still unclear. A panel study was carried out in Rome (Italy), aimed at evaluating the possible association between exposure to particulate air pollution and cardiac or respiratory impairments in subjects with pre-existing chronic obstructive lung disease (COPD).

A decrease of maximal hemoglobin oxygen saturation was associated with a unit (10 mg/m3) increase in PM2.5 levels on the same day (-0.3%; 95% CI = -0.1.% - -0.5%). A unit increase in PM2.5 at lag 0 was related to a linear increase in the average heart rate (3.50 beats / minute; 95% CI = 1.6 - 5.4). An increase in heart rate variability (standard deviation of the average heart rate) was also evident (1.10; 95% CI = 0.04 - 2.17). Pulmonary function parameters (FVC, FEV1 and FEF25–75) showed an association with PM2.5 levels recorded during the previous two days: for FEV1 (% of predicted; mean = 70%; SD = 17.7%; 158 person-days), the estimated b coefficient at lag 1 was -0.68 (SE = 0.30). When the outcome variables were regressed against PM10 daily levels, similar but lower effects were observed.

Conclusions

A decrease in oxygen saturation and increases in pulse rate and heart rate variability were found to be associated with ambient concentration of fine particles. A heart rate acceleration may well result either from impairment of autonomic nervous cardiac control or in response to hypoxia.